Development and Evaluation of Patient Information Leaflet for Diabetic Foot Ulcer Patients

Investigating the Knowledge of Prebiotics, Probiotics, and Synbiotics That May Help to Improve the Gut-Organ Axis Function in Middle-Aged and Older Adults

BACKGROUND AND AIMS

The use of gut biotics, including probiotics, prebiotics, and synbiotics, has shown substantial potential in the management of various health conditions possibly through the gut-organ axis. The role of gut biotics in modulating the gut-brain axis is becoming evident with more research focusing on this intervention. Improvement of gut-organ axis function is possible by using food-related products called gut biotics. However, there is limited comprehension of the knowledge and use of these intestinal or gut biotics. Our aim was to recognize knowledge gaps and assess the improvement of understanding following an education intervention.

METHODS

A single-arm study encompassing a convenient sample of 161 inpatient and outpatient subjects aged 50 years and older was conducted at the University of Alberta Hospital from June to August 2023. Knowledge about gut biotics was evaluated using a structured questionnaire consisting of 16 questions and involving six thematic areas. To ensure validity, the questionnaire was pre-tested on 10 physicians and residents who were not part of the study. The questionnaire was administered to study subjects prior to receiving an information sheet about gut biotics. Two weeks after receiving the information sheet, all participants were contacted by phone, and the same questionnaire was administered again. Of the 161 patients, 122 completed the pre-intervention and post-intervention questionnaires and were considered in the analysis.

RESULTS

The mean age of the participants was 72 years (SD: 10.8), 57% comprised women, and 39% had less than a high school education. The proportion of polypharmacy and multimorbidity was 87% and 97%, respectively. Following the intervention, there was a noticeable enhancement in knowledge across all the themes, with statistical significance (p<0.001) observed in 14 out of 16 questions as determined by the homogeneity statistical test.

CONCLUSIONS

Knowledge gaps in gut biotics were prevalent among study participants, and the educational intervention effectively contributed to the enhancement of knowledge. The results of this study provide valuable information for the development of targeted health education strategies focusing on gut biotics, which may play a role in improving gut-organ axis function.

Development of Podcasts in a Hospital Setting: A User-Centered Approach

Patient information plays a pivotal role in preparing individuals for hospital visits and empowering them to actively participate in decision-making processes regarding their healthcare. However, many patients face challenges related to reading comprehension. In response, podcasts have become a popular, user-friendly medium for sharing essential and easily understandable information in an engaging format.The aim of the present project was to use a user-centered approach to develop podcasts providing patient information prior to hospital visits. We aimed to describe the steps of the development in detail with the purpose of inspiring podcast development in the future.In Phase 1 we conducted interviews with patients and focus groups with clinicians based on the "empathy map" method, with the purpose of exploring patients' needs on which to subsequently build the podcasts' content and format. In Phase 2 we produced and refined the podcasts on the basis of feedback from clinician- and patients representatives.Our results indicated the importance of clear and concise language, personalization of communication, and content alignment with patients' needs. Our project resulted in a description of each step of the development that can be used as inspiration for others who wish to take a user-centered approach to podcast development.

Health Education for Chronic Kidney Disease Patients Not on Dialysis Through the Pictorial Patient Information Leaflet

Background: Educating the patient with patient information leaflets is helpful to increase understanding and awareness about chronic kidney disease. Various educational materials are available online, but their quality is mixed. The content was found to be unreliable or incomprehensible. Objective: The study aimed to develop, validate, test the readability, translation, and design of the patient information leaflet and focused on assessing patients' knowledge levels using questionnaires after providing the validated patient information leaflet. Methods: A prospective study was conducted among chronic kidney disease patients who were not on dialysis. The patient information leaflet was prepared based on experts' opinions and a thorough review of various resources. Experts validated the content of the patient information leaflet through the content validity index. After being validated, the Baker Able leaflet design scale was used to evaluate the layout and design. Knowledge assessment questions were validated using item-content validity index scores to assess patient knowledge before and after providing the patient information leaflet. Results: A total of 60 randomly selected chronic kidney disease patients were enrolled. The content validity index of the patient information leaflet was found to be 0.9. The Baker Able leaflet design score was found to be 25. Knowledge was assessed and it showed that score had increased from 42 ± 6.95 to 73.5 ± 6.70, respectively, with a P-value <0.000. Conclusion: This study concluded that the patient information leaflet was developed based on standard procedures. Significant improvement was seen in patients' knowledge after utilizing a validated patient information leaflet.

Patient education information material assessment criteria: A scoping review

BACKGROUND

Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources.

OBJECTIVE

This paper aims to identify these criteria and recognize the tools or methods used to evaluate them.

METHODS

National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included.

RESULTS

Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability.

CONCLUSION

This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.

Knowledge, Practice and Attitude towards Foot Ulcers and Foot Care among Adults Living with Diabetes in Tobago: A Qualitative Study

Globally, the prevalence of diabetes has risen significantly by 62% over the last ten years. A complication of unmanaged diabetes is diabetic foot ulcer (DFU), which adversely affects the quality of life of individuals with diabetes and inflicts a huge economic burden on the family, government, and health care services. However, this complication is preventable with adequate patient knowledge and practice regarding DFU and foot care. The present study was aimed at assessing the knowledge, attitude, and practice of adults with diabetes on foot ulcers and foot care in Tobago using a qualitative exploratory design. Purposeful sampling technique was used to recruit 20 participants from the lifestyle and diabetes foot clinics of Scarborough Health Centre, Tobago. Telephone interviews were conducted with the use of a semi-structured interview guide. The data obtained from participants were analyzed using thematic content analysis. Four major themes, namely foot ulcer problems, participants’ knowledge on DFU, knowledge on foot care, and practice and attitude of foot care, emerged from the study. The findings from the study revealed that the majority of participants had poor knowledge regarding DFU but exhibited awareness about foot care, especially on foot cleaning and inspection, preventing irritation after washing, appropriate footwear, and not walking barefooted. The participants had good attitudes and practices of foot care despite their poor knowledge of DFU. However, participants reported inadequate health education on DFU and foot care from healthcare personnel. There should be improved health education, information, and communication on DFU and foot care centred and tailored to the understanding of people living with diabetes. This will prevent DFU and reduce the mortality arising from this complication, which is a major target of the sustainable development goals (SDG) in mitigating the burden of non-communicable diseases (NCD) such as diabetes.

User testing a patient information resource about potential complications of vaginally inserted synthetic mesh

BACKGROUND

Vaginal mesh implants are medical devices used in a number of operations to treat stress urinary incontinence and pelvic organ prolapse. Although many of these operations have delivered good outcomes, some women have experienced serious complications that have profoundly affected their quality of life. To ensure that evolving patient information is up-to-date, accurate and appropriate, the Transvaginal Mesh Oversight Group 'user-tested' a newly developed Scottish patient resource, the first to focus exclusively on the issue of complications. The aim of this research was to gather feedback on usability, content, language and presentation to inform the development of the resource from a user perspective.

METHODS

The experience of using the patient resource was captured through semi-structured interviews that followed a 'think-aloud' protocol. The interviewer observed each participant as they went through the resource, asking questions and making field notes. Participants' comments were then categorised using a validated model of user experience and subsequently analysed thematically.

RESULTS

Thirteen people participated in the user testing interviews, including women with lived experience of mesh implants (n = 7), a convenience sample of staff working for Healthcare Improvement Scotland (n = 5) and a patient's carer (n = 1). The majority of participants considered the resource as clear and helpful. Respondents reported that some presentational aspects promoted usability and understandability, including the use of a font that is easy to read, bullet lists, coloured headings and simple language. Barriers included the reliance on some technical language and an explicit anatomical diagram. Participants endorsed the valuable role of health professionals as co-mediators of patient information.

CONCLUSIONS

The findings illustrate the value of undertaking in-depth user-testing for patient information resources before their dissemination. The study highlighted how the direct guidance or navigation of a patient information resource by a health professional could increase its salience and accuracy of interpretation by patients, their families and carers. These insights may also be useful to other developers in improving patient information.

Development and validation of patient information leaflet for coronary heart disease patients

Background

Patient information leaflets (PILs) are effectively used to improve the patient's knowledge about medications, disease, diet, and lifestyle modifications.

Aim

This study aims to develop and evaluate PILs for coronary heart disease patients.

Materials and Methods

Primary, secondary, and tertiary resources were used to develop PILs. The developed PILs were validated by four doctors, four academic pharmacists, and one dietician. PILs design and layout was prepared using barker able leaflet design (BALD) criteria. PILs readability was assessed using the Flesch Reading Ease test (FRE), Flesch-Kincaid Grade Level (FKGL), and user readability methods. User opinion on PILs content and design was obtained from patients.

Results

The FRE and FKGL readability scores were 61.5 and 7.4, respectively. The BALD criteria scores for English, Kannada, and Malayalam PILs were 28, 27, and 26, respectively. The overall user testing readability means scores had significantly improved from 45 to 79.30. Nearly 82.55% of patients rated the PILs as good design and content.

Conclusion

The developed leaflet met the standard criteria for easy reading and comprehension. The majority of the patients gave good opinion on the content and design of the PILs.

[Application of skin stretching device in repair of diabetic foot wound]

Objective

To evaluate the clinical value of skin stretching device in repair of diabetic foot wound.

Methods

A retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n=24) and with the vacuum sealing drainage combined with skin graft (control group, n=24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups ( P>0.05). Both patients in 2 groups were treated with sensitive antibiotics according to the results of bacterial culture.

Results

One case in control group was infected and the skin graft failed, and 1 case in trial group was infected after the treatment, and the two wounds healed after symptomatic treatment. The wounds of the other patients healed successfully, and the healing time of the trial group was significantly shorter than that of the control group [(12.8±11.6) days vs. (22.3±10.4) days; t=2.987, P=0.005). All patients were followed up 3-12 months after operation, and no wound dehiscence or recurrence occurred during follow-up.

Conclusion

Compared with the vacuum sealing drainage combined with skin graft, the application of skin stretching device in the repair of diabetic foot wound has advantages, such as easy to operate, shorten the wound healing time, and the appearance of wound was similar with the adjacent skin.